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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
12329
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l?. 0 ~ 13 r-- u (I t..
ADDRESS
PLAN NO.
OWNER
DESIGNER
BUILDING CONTRACTOR
SIZ~ Sq. Ft.
Foundation g r:;<-:> (-
rl ÞI1f!; # Stories(:) c/.,cJf' ( Height
Class of Const. ~ Occupancy Permii ,/1./0
HEATING CONTRACTOR
Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
(\)=f<-e r-
Electric Servo
New 0 Change 0 Temp 0
Type- Voits- Amps-
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR f),u tA. .. r-
_Lav
_WH
_Sh
_Disp
_DW
_WSoft
_DF
- CBasln
_BT
_Sink
Other
_FDr
_LTub
_SP
_Ur
- San. Sewer
_Storm Sewer
_WC
_Eject
_SS
_Water
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Park Dedication $ ~..
Flnal/O.P.
FEES: Valuation
ISSUED BY
ADDRESS
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t'/t? lÞ.';1n<R<;;//
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SIGNATURE
DATE
2':S.?-;2'7D :3
TELEPHONE.